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Metastases of Colorectal Carcinoma: Comparison of Soft- and Hard-Copy Helical CT Interpretation¹

¹ From the Departments of Radiology (M.E.J.P., M.N.J.M.W., E.C.J., J.L.B.) and Surgery (C.J.H.v.d.V.), Leiden University Medical Center, Albinusdreef 2, C3-Q, 2333 ZA Leiden, the Netherlands. Received February 1, 2002; revision requested March 18; final revision received September 17; accepted September 30. Address correspondence to M.E.J.P. (e-mail: m.e.j.pijl@lumc.nl).

PURPOSE: To compare soft- and hard-copy computed tomographic (CT) image interpretation with regard to evaluation time and detection rates for hepatic and extrahepatic colorectal metastases in candidates for liver surgery.

MATERIALS AND METHODS: In 20 patients with a history of colorectal carcinoma, two radiologists independently evaluated CT data sets. Focal hepatic lesions were characterized as benign or malignant by using a five-point scale. In each patient, soft-copy readouts and hard-copy printouts were compared for nonenhanced hepatic, contrast material–enhanced hepatic, and contrast-enhanced extrahepatic data sets. A stopwatch was used to document evaluation time. Ninety-two hepatic metastases and six extrahepatic metastatic recurrences were detected with the standard of reference—surgical, intraoperative ultrasonographic, and histologic findings.

RESULTS: Both observers evaluated the contrast-enhanced hepatic data set significantly faster (P = .026 and .009) by using soft-copy readouts. The contrast-enhanced extrahepatic data set was also evaluated significantly faster (P = .010 and .006) with soft-copy readouts. Detection of hepatic and extrahepatic tumor with soft-copy readouts is not significantly superior to that with hard copies. Detection rates of hepatic metastases for nonenhanced and contrast-enhanced CT for both observers ranged from 50%–80% (46–74 of 92) for soft-copy readouts and 46%–75% (42–69 of 92) for hard copies. Interobserver agreement was highest for contrast-enhanced soft-copy readouts for hepatic metastases.

CONCLUSION: Soft-copy readouts of contrast-enhanced CT data sets for the detection of hepatic metastases and extrahepatic metastatic recurrences were evaluated significantly faster than were hard copies, with at least equal sensitivity and with excellent interobserver agreement.

© RSNA, 2003

Index terms: Computed tomography (CT), comparative studies, 761.12111, 761.12114, 761.12115 • Computed tomography (CT), helical, 78.12115 • Computed tomography (CT), image display and recording • Liver neoplasms, CT, 761.12111, 761.12114, 761.12115 • Liver neoplasms, metastases, 761.3327

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